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edwards oral path test 4


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completely radiolucent
commonly associated w/ impacted tooth (max canine)
Adenomatoid Odontogenic Tumor (AOT
loosening of teeth, uncommon, perio membrane origin
Squamous Odontogenic Tumor
Liesegang (lamellar) rings
Calcifying Epithelial Odontogenic Tumor (CEOT)
multilocular/honeycomb RL
Odontogenic Myxoma
rare, Max = ant to 1st molars, Mand = posterior to 1st molars. Non-specific RL.
Central Odontogenic Fibroma
Bump on gums
Peripheral Odontogenic Fibroma
teens – early 20’s à RADIOPAQUE mass of a VITAL tooth surrounded by a RADIOLUCENCENT ring
RADIOPACITY +/- impacted tooth w/ RADIOLUCENCENT capsule
NON-aggressive odontogenic tumor affecting the mandibular molar-ramus area of children and young adults
Ameloblastic Fibroma
odontoma like radiopacities
Ameloblstic Fibro-odontoma
Malignant odontogenic tumors
Clear cell odontogenic carcinoma (rare, clear cytoplasm, epithelial islands)
Pericoronal unilocular
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Periapical unilocular
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Unilocular other locations
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Mixed Radiolucent/opaque
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exaggerated lingual pit à early decay, tx: prophylactic fill. Permanent max laterals most common
Dens in Dente (dens invaginatus):
tubercle in center of occ table w/ pulp horn, relatively common. Bilateral PM's (Leung's) Asians, Inuits, Native Americans.
Dens Evaginatus
physologic(diet, occlusion
pathologic(aggressive brushing, smoking/chewing tobacco),
chemical dissolution
caused by environment + genetics
Anodontia, polygenic
abscessed primary tooth à pit formation
Turner’s Tooth
enamel hypoplasia
Amelogenesis imperfecta 3 types
hypocalcified, hypoplastic, hypomaturated
bell shaped crowns
Dentinogenesis Imperfecta
chevron look
Dentin dysplasia
Ghost teeth
Regional) Odontodysplasia
No relation to inflammation trauma or systemic disease
Pulpal Calcification
pink tooth
Internal Resorption
may be caused by chronic inflammation, cysts, benign/malignant tumors, trauma, reimplantation, impaction, ortho, coronal resorption
External Resorption
green/brown primary teeth
Erythroblastosis fetalis
red/brown teeth
Congenital porphyria
apices of mandibular incisors, more common in Black females 20-30’s causing multiple radiolucent lesions of CITAL teeth
Periapical cementoosseous dysplasia
NOT in mandibular incisors, 90% women, RADIOLUCENT/mixed
Focal cementoosseous dysplasia
black women, multiquadrant +/- RADIOLUCENCIES, prone to osteomyelitis
Florid cementoosseous dysplasia
Slow expansion of jaws and craniofacial bones à well circumscribed defined border, mixed RL
Ossifying fibroma
mutation of GNAS1 Gene
Fibrous dysplasia
Ground Glass appearance
Fibrous dysplasia
Nocturnal pain (most others cause no pain) relieved by NSAIDs
Multiple osteomas
Gardner’s syndrome
Benign proliferation of bone common in paranasal sinuses
area of increased bone density of unknown etiology = increased/well defined RP usually< 1cm, NOT associated with inflamed tooth.
Ideopathic osteosclerosis aka dense bone island
reaction due to chronic pulpal inflammation
Condensing Osteitis aka focal sclerosing osteomyelitis
Benign proliferation of multineuclated giant cells of jaws, most multilocular / some unilocular
Central Giant Cell Granuloma
soap bubble⬝ +/- sun-ray-like appearance
Hemangioma of Bone
Can Mimic other intraosseous lesions
Hemangioma of Bone
Knees – teens, Jaws – 30’s
elev serum alkaline phospatase, Histo: mosaic pattern, “reversal lines”, Radio: “cotton wool”
irreg wide PDL, “sun-ray”
cartilage producing cells, rare, ant max
Young patients (children/teens), malignancy of bone
Ewing’s Sarcoma/Primative Neuroectodermal Tumor:
soft tissue variant of ewings sarcoma
Primative Neuroectodermal Tumor
Mult “punched out” RL – non-corticated
Multiple Myeloma
Malig plasma cell neoplasm
Multiple Myeloma
Single sight of bone destruction
Solitary Plasmacytoma of Bone
Jaw bones - ill-defined/subtle RL, alveolar bones lass, vague pain, parasthesia
Non-Hodgkin Lymphomas
Histo: “starry sky”
Burkitt Lymphoma
loose teeth, paresthesia
Metastatic Dx
Metastatic Dx to bones (primarily carcinoma) vs osteosarcoma in adults
Metastatic Dx to bones (primarily carcinoma) > osteosarcoma in adults
Young children, multiple osteolytic lesions of skull/jaw
Langerhans Cell Histocytosis
< one month duration, usually infectious, pain is primary Sx, NOT evident radiographically until 60% bone demineralized; purulent;
Acute Osteomyeliti
mild-moderate pain; NOTPurulent; moth-eaten radiographic appearance, mandibular molar MOST COMMON site, Swelling common
Chronic Osteomyeliti
Garre’s osteomyelitis
Chronic osteomyelitis w/ proliferative periostiti
associated w/ infected mandibular molar *ESP. in CHILDREN or as a post extraction complication; asymptomatic-mildly tender bony hard swelling w/ normal appearing overlying mucosa.
Chronic osteomyelitis w/ proliferative periostiti
onion skinning
Chronic osteomyelitis w/ proliferative periostiti
(looks like florid cementoosseus dysplasia
Diffuse Sclerosing osteomyeliti
condensing osteitis
Focal Sclerosing osteomyeliti
dry socket
Alveolar Osteitis
Radiation injury to bone 3 h's
1. Hypovascular; 2. Hypocellular; 3. hypoxic
delayed eruption/ supernumerary
Cleidocranial dysplasia/Gardner/Crouzon
delayed eruption/ missing teeth
downs / osteopetrosis
too few/too many teeth
Ehlers-Danlos, Sturge Weber
too few teeth
Ectodermal dysplasia / Hurler
premature exfoliation
Papillon LeFevre, Hyphosphatasia, Dentinal dysplasia type 1, Regional odontodysplasia
prolonged retention of primary teeth and eruption failure of permanent teeth and often exhibits supernumary teeth
Cleidocranial dysplasia
bilateral asymptomatic swelling of the jaws, upturned gaze, multilocular RL’s = giant cell lesions. Permanent teeth may be malformed or missing
Frog-like" facies
Crouzon's Syndrome
most common craniosynostosis syndromes
Crouzon's and Apert’s
Autosomal dominant, MULTIPLE - OKC's, basal cell carcinomas and epidermoid cysts. Palmar-plantar pitting. Large calvaria, Calcification of falx cerebri, bifid ribs, ovarian fibromas.
Basal Cell Nevus Syndrome
hypotrichosis (less than normal amount of hair on head), hypohydrosis, cone-shaped teeth. Heat intolerance
Ectodermal Dysplasia
deficiency of lysosomal enzymes
Clinically evident by age two--patient usually dies by age 25 due to cardiopulmonary disease, short stature; hepatosplenomegaly; hernias normal mental capacity; sleep apnea-airway obstruction; corneal clouding Dysostosis multiplex; thickened skin; hearin
Hurler-Scheie Syndrome
CT disorder-defect [fibrillin (FBN1) gene]
Marfan's Syndrome
Fragile bones inborn error of collagen
Osteogenesis Imperfecta
Severe micrognathia, high palate, feeding problems
Pierre Robin Syndrome
bird-like or fish-like facies
Treacher-Collins Syndrome
mandibular hypoplasia; midface deficiency, colobomas (notches
Treacher-Collins Syndrome
rubber man
Ehlers-Danlos Syndrome
Joint hypermobility; skin hyperextensibility. Cardiovascular anomalies; possible bleeding problems, need antibiotic prophylaxis
Ehlers-Danlos Syndrome
Tall forehead with flattened occipital; premature suture closure, ocular proptosis with downward slant to corners of eye, mid-face hypoplasia; mouth breather (Class III with anterior open bite, syndactyly of fingers and toes, mental retardation; acne-lik
Apert's Syndrome
Unilateral localized overgrowth of facial soft tissue, bones, and teeth
Hemifacial Hypertrophy
Opposite of Hemifacial Hypertrophy with localized scleroderma (hardening and thickening of skin
Parry-Romberg Syndrome
midface hypoplasia; delayed eruption, hypodontia and microdontia more common; fissured enlarged tongue; greater incidence of periodontal disease and infections; crossbite common; mouth-breathers, thyroid dysfunction in 50%, increased risk of ALL (leukemi
Down syndrome
Hyperkeratotic palms and soles, lack of resistance to periodontal disease; defective neutrophil chemotaxis à tooth loss within 2-3 years post-eruption No Tx
Papillon-Lefevre Syndrome
auriculo-temporal syndrome, following parotid surgery, trauma, mandibular surgery, parasympathetic nerve fibers may be severed à sweating, flushing, warmth, and occasional mild pain during enhanced salivary stimulation when eating food
Frey syndrome
Periodic fever, Aphthous ulcers, Pharyngitis, Cervical Adenitis in children
Elevated serum alkaline phosphatase My hat doesn’t fit anymore
Paget's Disease of Bone
pituitary adenoma after puberty
enlargment of the hands and feet
deficiency of tissue and serum alkaline phosphatase, increases serum phosphoethanolamine, beaten copper skull appearance,premature loss of primary teeth (lack cementum),enlarged pulp chamber in primary teeth with alveolar bone loss, short stature, bowed
stones, moans, bones and groans
parathyroid adenoma; secondary form due to renal failure
Premature exfoliation of primary teeth or rapid eruption of permanent teeth dental erosion 3x as likely, osteoporosis, females 5:1; Grave's disease, heat intolerance, weight loss, hyperhydrosis, diarrhea, thin hair, exophthalmos
Grave's disease
Delayed dental development. Put on weight

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